1. Correction of presbyopia by central biaspheric multifocal LASIK (PRESBYMAX ® ) in myopic patients. Jorge L. Alió MD, PhD, Dolores Ortiz PhD, Esperanza Sala, MSc Ana B. Plaza, MSc VISSUM Instituto Oftalmológico de Alicante Universidad Miguel Hernández Alicante (Spain)

2. Financial disclosure –AcuFocus, Inc. - D –Akkolens - D,A –Alcon Laboratories, Inc. - D –Bausch & Lomb Surgical - D,A –Carl Zeiss Meditec - D –Chemedica - D –Eyemaginations - A –Index Instruments -P –IntraLase Corporation - D CategoryCodeSpecific Financial Interest ProductPI earn royalty or derive other financial gain from an ophthalmic product or service. InvestorRI have a significant investment interest in a company that makes/develops/provides ophthalmic products or services. ConsultantA I receive a retainer, ad hoc fees, or other consulting income from a company that makes/develops/provides ophthalmic products or services. BI am a member of the speaker's bureau of a company that makes/develops/provides ophthalmic products or services. CI provide practice management or marketing consulting services to ophthalmic practices. ResearchDMy research is fully or partially funded by a company that makes/develops/provides ophthalmic products or services. TravelE My travel expenses have been reimbursed, paid in full or subsidized, by a company that makes/develops/provides ophthalmic products or services. EmployeeyI am a full-time employee of a company that makes/develops/provides ophthalmic products or services ZI am a part-time employee of a company that makes/develops/provides ophthalmic products or services SpouseS My spouse has a financial relationship with a company that makes/develops/produces ophthalmic products or services, encompassing either royalties, investment, consulting/speakers bureau, research grants, travel reimbursement or employment.

3. Purpose To study refractive and visual outcomes of central presbylasik technique (PresbyMax ® ), based on the creation of a central area for near vision (+2 D of addition), in myopic patients.

4. Patients Study design: Prospective, non comparative pilot study that included a total of 42 myopic eyes with age between 40 and 56 years. Inclusion criteria: myopia –4 (D), astigmatism –2 (D), corneal curvature between 40 and 48 D, pachymetry >500, and near vision of J3 with addition of +1.50 D.

5. Methods The ablation pattern was performed using the Esiris excimer laser (Schwind, Frankfurt,Germany), centred in corneal vertex and biaspheric profile. The main outcome measures were refraction, uncorrected and best corrected visual acuities for near and distance, corneal aberrations (spherical and coma) and patient satisfaction.

6. Results: spherical equivalent At 6 months after surgery, the spherical equivalent refraction was –0.21±0.37 (D).

7. Visual acuity The distance decimal visual acuity with without correction 0.88±0.14.

8. Visual acuity Mean near decimal visual acuity without correction 0.93±0.25. Mean near distance corrected decimal visual acuity was 0.53±0.26.

9. Addition The addition change from 1.3 preop to 0.88D after 6 months postoperative.

10. Results: Corneal aberrations Spherical corneal aberrations showed a trend towards positive increase while coma corneal aberration did not change.

11. Conclusions Central presbylasik with biaspherical profile may be used to improve functional near vision in patients with presbyopia associated with low to moderate myopia. 70% of patients could dispense with the use of glasses both for far and near 6 months after the surgery.